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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Lalau, J. D. Azzoug, M. L. Kajbaf, F. Briet, C. Desailloud, R. |
| Description | Author Affiliation: Lalau JD ( Service d'endocrinologie et de nutrition, hôpital Sud, centre hospitalier universitaire, 80054 Amiens cedex 1, France); Azzoug ML ( Service d'endocrinologie et de nutrition, hôpital Sud, centre hospitalier universitaire, 80054 Amiens cedex 1, France.); Kajbaf F ( Service d'endocrinologie et de nutrition, hôpital Sud, centre hospitalier universitaire, 80054 Amiens cedex 1, France); Briet C ( Service d'endocrinologie et de nutrition, centre hospitalier universitaire du Kremlin-Bicêtre, Paris, France.); Desailloud R ( Service d'endocrinologie et de nutrition, hôpital Sud, centre hospitalier universitaire, 80054 Amiens cedex 1, France) |
| Abstract | AIM: These case reports demonstrate that, at the individual level, blood metformin concentrations and metformin effects on lactate do not always correlate. METHODS: We report here on two unusual cases: metformin accumulation in the absence of hyperlactataemia; and metformin-induced hyperlactataemia with no metformin accumulation. RESULTS: Patient #1 presented with severe kidney failure, severe acidosis (pH: 7.04), normal lactataemia (0.90 mmol/L) and marked metformin accumulation. Patient #2 presented with hyperlactataemia, even after dose reduction, during otherwise well-tolerated metformin treatment. Arterial lactate levels were 8.8, 8.2 and 4.7 mmol/L during metformin therapy with daily doses of 2550, 1700 and 850 mg, respectively. After withdrawal, metformin was reintroduced for 5-day periods at 500 mg/day up to 2000 mg/day with washout intervals. Lactate concentration, normal at baseline, rapidly exceeded 2 mmol/L after metformin administration. CONCLUSION: These clinical data suggest a new concept for metformin therapy: there may be either resistance or, conversely, hypersensitivity to metformin effects on lactate generation according to the individual patient. |
| File Format | HTM / HTML |
| ISSN | 12623636 |
| Issue Number | 3 |
| Volume Number | 40 |
| e-ISSN | 18781780 |
| Journal | Diabetes & Metabolism |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2014-06-01 |
| Publisher Place | France |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Metabolism Discipline Endocrinology Acidosis, Lactic Chemically Induced Diabetes Mellitus, Type 2 Drug Therapy Hyperlactatemia Hypoglycemic Agents Adverse Effects Lactic Acid Blood Metformin Aged Drug Administration Schedule Drug Hypersensitivity Drug Resistance Female Humans Administration & Dosage Metabolism Male Middle Aged Treatment Outcome Case Reports Journal Article |
| Content Type | Text |
| Resource Type | Case study Article |
| Subject | Endocrinology, Diabetes and Metabolism Internal Medicine Endocrinology |
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